How to Do the Work – by Dr. Nicole LaPera
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We have reviewed some self-therapy books before, and they chiefly have focused on CBT and mindfulness, which are great. This one’s different.
Dr. Nicole LaPera has a bolder vision for what we can do for ourselves. Rather than giving us some worksheets for unraveling cognitive distortions or clearing up automatic negative thoughts, she bids us treat the cause, rather than the symptom.
For most of us, this will be the life we have led. Now, we cannot change the parenting style(s) we received (or didn’t), get a redo on childhood, avoid mistakes we made in our adolescence, or face adult life with the benefit of experience we gained right after we needed it most. But we can still work on those things if we just know how.
The subtitle of this book promsies that the reader can/will “recognise your patterns, heal from your past, and create your self”.
That’s accurate, for the content of the book and the advice it gives.
Dr. LaPera’s focus is on being our own best healer, and reparenting our own inner child. Giving each of us the confidence in ourself; the love and care and/but also firm-if-necessary direction that a (good) parent gives a child, and the trust that a secure child will have in the parent looking after them. Doing this for ourselves, Dr. LaPera holds, allows us to heal from traumas we went through when we perhaps didn’t quite have that, and show up for ourselves in a way that we might not have thought about before.
If the book has a weak point, it’s that many of the examples given are from Dr. LaPera’s own life and experience, so how relatable the specific examples will be to any given reader may vary. But, the principles and advices stand the same regardless.
Bottom line: if you’d like to try self-therapy on a deeper level than CBT worksheets, this book is an excellent primer.
Click here to check out How To Do The Work, and empower yourself to indeed do the work!
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The Food For Life Cookbook – by Dr. Tim Spector
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We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.
The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.
The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.
Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.
Click here to check out the Food For Life Cookbook, and get cooking for life!
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Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money
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One owns a for-profit insurer, a venture capital company, and for-profit hospitals in Italy and Kazakhstan; it has just acquired its fourth for-profit hospital in Ireland. Another owns one of the largest for-profit hospitals in London, is partnering to build a massive training facility for a professional basketball team, and has launched and financed 80 for-profit start-ups. Another partners with a wellness spa where rooms cost $4,000 a night and co-invests with “leading private equity firms.”
Do these sound like charities?
These diversified businesses are, in fact, some of the country’s largest nonprofit hospital systems. And they have somehow managed to keep myriad for-profit enterprises under their nonprofit umbrella — a status that means they pay little or no taxes, float bonds at preferred rates, and gain numerous other financial advantages.
Through legal maneuvering, regulatory neglect, and a large dollop of lobbying, they have remained tax-exempt charities, classified as 501(c)(3)s.
“Hospitals are some of the biggest businesses in the U.S. — nonprofit in name only,” said Martin Gaynor, an economics and public policy professor at Carnegie Mellon University. “They realized they could own for-profit businesses and keep their not-for-profit status. So the parking lot is for-profit; the laundry service is for-profit; they open up for-profit entities in other countries that are expressly for making money. Great work if you can get it.”
Many universities’ most robust income streams come from their technically nonprofit hospitals. At Stanford University, 62% of operating revenue in fiscal 2023 was from health services; at the University of Chicago, patient services brought in 49% of operating revenue in fiscal 2022.
To be sure, many hospitals’ major source of income is still likely to be pricey patient care. Because they are nonprofit and therefore, by definition, can’t show that thing called “profit,” excess earnings are called “operating surpluses.” Meanwhile, some nonprofit hospitals, particularly in rural areas and inner cities, struggle to stay afloat because they depend heavily on lower payments from Medicaid and Medicare and have no alternative income streams.
But investments are making “a bigger and bigger difference” in the bottom line of many big systems, said Ge Bai, a professor of health care accounting at the Johns Hopkins University Bloomberg School of Public Health. Investment income helped Cleveland Clinic overcome the deficit incurred during the pandemic.
When many U.S. hospitals were founded over the past two centuries, mostly by religious groups, they were accorded nonprofit status for doling out free care during an era in which fewer people had insurance and bills were modest. The institutions operated on razor-thin margins. But as more Americans gained insurance and medical treatments became more effective — and more expensive — there was money to be made.
Not-for-profit hospitals merged with one another, pursuing economies of scale, like joint purchasing of linens and surgical supplies. Then, in this century, they also began acquiring parts of the health care systems that had long been for-profit, such as doctors’ groups, as well as imaging and surgery centers. That raised some legal eyebrows — how could a nonprofit simply acquire a for-profit? — but regulators and the IRS let it ride.
And in recent years, partnerships with, and ownership of, profit-making ventures have strayed further and further afield from the purported charitable health care mission in their community.
“When I first encountered it, I was dumbfounded — I said, ‘This not charitable,’” said Michael West, an attorney and senior vice president of the New York Council of Nonprofits. “I’ve long questioned why these institutions get away with it. I just don’t see how it’s compliant with the IRS tax code.” West also pointed out that they don’t act like charities: “I mean, everyone knows someone with an outstanding $15,000 bill they can’t pay.”
Hospitals get their tax breaks for providing “charity care and community benefit.” But how much charity care is enough and, more important, what sort of activities count as “community benefit” and how to value them? IRS guidance released this year remains fuzzy on the issue.
Academics who study the subject have consistently found the value of many hospitals’ good work pales in comparison with the value of their tax breaks. Studies have shown that generally nonprofit and for-profit hospitals spend about the same portion of their expenses on the charity care component.
Here are some things listed as “community benefit” on hospital systems’ 990 tax forms: creating jobs; building energy-efficient facilities; hiring minority- or women-owned contractors; upgrading parks with lighting and comfortable seating; creating healing gardens and spas for patients.
All good works, to be sure, but health care?
What’s more, to justify engaging in for-profit business while maintaining their not-for-profit status, hospitals must connect the business revenue to that mission. Otherwise, they pay an unrelated business income tax.
“Their CEOs — many from the corporate world — spout drivel and turn somersaults to make the case,” said Lawton Burns, a management professor at the University of Pennsylvania’s Wharton School. “They do a lot of profitable stuff — they’re very clever and entrepreneurial.”
The truth is that a number of not-for-profit hospitals have become wealthy diversified business organizations. The most visible manifestation of that is outsize executive compensation at many of the country’s big health systems. Seven of the 10 most highly paid nonprofit CEOs in the United States run hospitals and are paid millions, sometimes tens of millions, of dollars annually. The CEOs of the Gates and Ford foundations make far less, just a bit over $1 million.
When challenged about the generous pay packages — as they often are — hospitals respond that running a hospital is a complicated business, that pharmaceutical and insurance execs make much more. Also, board compensation committees determine the payout, considering salaries at comparable institutions as well as the hospital’s financial performance.
One obvious reason for the regulatory tolerance is that hospital systems are major employers — the largest in many states (including Massachusetts, Pennsylvania, Minnesota, Arizona, and Delaware). They are big-time lobbying forces and major donors in Washington and in state capitals.
But some patients have had enough: In a suit brought by a local school board, a judge last year declared that four Pennsylvania hospitals in the Tower Health system had to pay property taxes because its executive pay was “eye popping” and it demonstrated “profit motives through actions such as charging management fees from its hospitals.”
A 2020 Government Accountability Office report chided the IRS for its lack of vigilance in reviewing nonprofit hospitals’ community benefit and recommended ways to “improve IRS oversight.” A follow-up GAO report to Congress in 2023 said, “IRS officials told us that the agency had not revoked a hospital’s tax-exempt status for failing to provide sufficient community benefits in the previous 10 years” and recommended that Congress lay out more specific standards. The IRS declined to comment for this column.
Attorneys general, who regulate charity at the state level, could also get involved. But, in practice, “there is zero accountability,” West said. “Most nonprofits live in fear of the AG. Not hospitals.”
Today’s big hospital systems do miraculous, lifesaving stuff. But they are not channeling Mother Teresa. Maybe it’s time to end the community benefit charade for those that exploit it, and have these big businesses pay at least some tax. Communities could then use those dollars in ways that directly benefit residents’ health.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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How Much Weight Gain Do Antidepressants Cause?
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There’s a lot of talk in the news lately about antidepressants and weight gain, so let’s look at some numbers.
Here’s a study from July 2024 that compared the weight gain of eight popular antidepressants, and pop-science outlets have reported it with such snippets as:
❝Bupropion users were approximately 15–20% less likely to gain a clinically significant amount of weight than those taking the most common medication, sertraline.
The researchers considered weight gain of 5% or more as clinically significant.❞
Read in full: Study compares weight gain across eight common antidepressants
At this point, you might (especially if you or a loved one is on sertraline) be grabbing a calculator and seeing what 5% of your weight is, and might be concerned at the implications.
However, this is a little like if, in our This or That section, we were to report that food A has 17x more potassium than food B, without mentioning that food A has 0.01mg/100g and food A has 0.17mg/100g, and thus that, while technically “17x more”, the difference is trivial.
As a quick aside: we do, by the way, try to note when things like that might skew the stats and either wipe them out by not mentioning that they contain potassium at all (as they barely do), or if it’s a bit more, describing them as being “approximately equal in potassium” or else draw attention to the “but the amounts are trivial in both cases”.
Back to the antidepressants: in fact, for those two antidepressants compared in that snippet, the truth is (when we go looking in the actual research paper and the data within):
- sertraline was associated with an average weight change of +1.5kg (just over 3lb) over the course of 24 months
- bupropion was associated with an average weight change of +0.5kg (just under 1lb) over the course of 24 months
Sertraline being the most weight-gain-inducing of the 8 drugs compared, and bupropion being the least, this means (with them both having fairly even curves):
- sertraline being associated with an average weight change of 0.06kg (about 2oz) per month
- bupropion being associated with an average weight change of 0.02kg (less than 1oz) per month
For all eight, see the chart here in the paper itself:
Medication-Induced Weight Change Across Common Antidepressant Treatments ← we’ve made the link go straight to the chart, for your convenience, but you can also read the whole paper there
While you’re there, you might also see that for some antidepressants, such as duloxetine, fluoxetine, and venlafaxine, there’s an initial weight gain, but then it clearly hits a plateau and weight ceases to change after a certain point, which is worth considering too, since “you’ll gain a little bit of weight and then stay at that weight” is a very different prognosis from “you’ll gain a bit of weight and keep gaining it forever until you die”.
But then again, consider this:
Most adults will gain half a kilo this year – and every year. Here’s how to stop “weight creep”
That’s more weight gain than one gets on sertraline, the most weight-gain-inducing antidepressant tested!
What about over longer-term use?
Here’s a more recent study (December 2024) that looked at antidepressant use over 6 years, and found an average 2% weight gain over those 6 years, but it didn’t break it down by antidepressant type, sadly:
…which seems like quite a wasted opportunity, since some of the medications considered are very different, working on completely different systems (for example, SSRIs vs NDRIs, working on serotonin or norepinephrine+dopamine, respectively—see our Neurotransmitter Cheatsheet for more about those) and having often quite different side effects. Nevertheless, the study (despite collecting this information) didn’t then tabulate the data, and instead considered them all to be the same factor, “antidepressants”.
What this study did do that was useful was included a control group not on antidepressants so we know that on average:
- never-users of antidepressants gained an average of 1% of their bodyweight over those 6 years
- users-and-desisters of antidepressants gained an average of 1.8% of their bodyweight over those 6 years*
- continuing users of antidepressants gained an average of 2% of their bodyweight over those 6 years
*for this group, weight gain was a commonly cited reason for stopping taking the antidepressants in question
Writer’s anecdote: I’ve been on mirtazapine (a presynaptic alpha2-adrenoreceptor antagonist which increases central noradrenergic and serotonergic neurotransmission) for some years and can only say that I wish I’d been on it decades previously. I requested mirtazapine specifically, because I’m me and I know my stuff and considered it would most likely be by far the best fit for me out of the options available. Starting at a low dose, the only meaningful side effect was mild sedation (expected, and associated only with low-dose use); increasing after a couple of weeks to a moderate dose, that side effect disappeared and now the only remaining side effect is a slight dryness of the mouth, which is fine, as it ensures I remember to stay hydrated 🙂 anyway, my weight hasn’t changed (beyond very small temporary fluctuations) in the time I’ve been on mirtazapine. Disclaimer: the plural of anecdote is not data, and I can only speak for my own experience, and am not making any particular recommendation here. Your personal physiology will be different from mine, and may respond well or badly to any given treatment according to your own physiology.
Further considerations
This is touched on in the “Discussion” section of the latter paper (so do check that out if you want all the details, more than we can reasonably put here), but there are other factors to consider, for example:
- whether people were underweight/healthy weight/overweight at baseline (sometimes, a weight gain can be a good thing, recovering from an illness, and in the case of the illness that is depression, weight can swing either way)
- antidepressants changing eating and exercise habits (generally speaking: more likely to eat more and exercise more)
- body composition! How did they not cover this (neither paper did)?! Muscle weighs more than fat, and improvements in exercise can result in an increase in muscle and thus an increase in overall weight.
As researchers like to say, “this highlights the need for more high-quality studies to look into…” (and then the various things that went unexamined).
Want to know more?
Check out our previous main feature:
Antidepressants: Personalization Is Key!
Take care!
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Traveling To Die: The Latest Form of Medical Tourism
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In the 18 months after Francine Milano was diagnosed with a recurrence of the ovarian cancer she thought she’d beaten 20 years ago, she traveled twice from her home in Pennsylvania to Vermont. She went not to ski, hike, or leaf-peep, but to arrange to die.
“I really wanted to take control over how I left this world,” said the 61-year-old who lives in Lancaster. “I decided that this was an option for me.”
Dying with medical assistance wasn’t an option when Milano learned in early 2023 that her disease was incurable. At that point, she would have had to travel to Switzerland — or live in the District of Columbia or one of the 10 states where medical aid in dying was legal.
But Vermont lifted its residency requirement in May 2023, followed by Oregon two months later. (Montana effectively allows aid in dying through a 2009 court decision, but that ruling doesn’t spell out rules around residency. And though New York and California recently considered legislation that would allow out-of-staters to secure aid in dying, neither provision passed.)
Despite the limited options and the challenges — such as finding doctors in a new state, figuring out where to die, and traveling when too sick to walk to the next room, let alone climb into a car — dozens have made the trek to the two states that have opened their doors to terminally ill nonresidents seeking aid in dying.
At least 26 people have traveled to Vermont to die, representing nearly 25% of the reported assisted deaths in the state from May 2023 through this June, according to the Vermont Department of Health. In Oregon, 23 out-of-state residents died using medical assistance in 2023, just over 6% of the state total, according to the Oregon Health Authority.
Oncologist Charles Blanke, whose clinic in Portland is devoted to end-of-life care, said he thinks that Oregon’s total is likely an undercount and he expects the numbers to grow. Over the past year, he said, he’s seen two to four out-of-state patients a week — about one-quarter of his practice — and fielded calls from across the U.S., including New York, the Carolinas, Florida, and “tons from Texas.” But just because patients are willing to travel doesn’t mean it’s easy or that they get their desired outcome.
“The law is pretty strict about what has to be done,” Blanke said.
As in other states that allow what some call physician-assisted death or assisted suicide, Oregon and Vermont require patients to be assessed by two doctors. Patients must have less than six months to live, be mentally and cognitively sound, and be physically able to ingest the drugs to end their lives. Charts and records must be reviewed in the state; neglecting to do so constitutes practicing medicine out of state, which violates medical licensing requirements. For the same reason, the patients must be in the state for the initial exam, when they request the drugs, and when they ingest them.
State legislatures impose those restrictions as safeguards — to balance the rights of patients seeking aid in dying with a legislative imperative not to pass laws that are harmful to anyone, said Peg Sandeen, CEO of the group Death With Dignity. Like many aid-in-dying advocates, however, she said such rules create undue burdens for people who are already suffering.
Diana Barnard, a Vermont palliative care physician, said some patients cannot even come for their appointments. “They end up being sick or not feeling like traveling, so there’s rescheduling involved,” she said. “It’s asking people to use a significant part of their energy to come here when they really deserve to have the option closer to home.”
Those opposed to aid in dying include religious groups that say taking a life is immoral, and medical practitioners who argue their job is to make people more comfortable at the end of life, not to end the life itself.
Anthropologist Anita Hannig, who interviewed dozens of terminally ill patients while researching her 2022 book, “The Day I Die: The Untold Story of Assisted Dying in America,” said she doesn’t expect federal legislation to settle the issue anytime soon. As the Supreme Court did with abortion in 2022, it ruled assisted dying to be a states’ rights issue in 1997.
During the 2023-24 legislative sessions, 19 states (including Milano’s home state of Pennsylvania) considered aid-in-dying legislation, according to the advocacy group Compassion & Choices. Delaware was the sole state to pass it, but the governor has yet to act on it.
Sandeen said that many states initially pass restrictive laws — requiring 21-day wait times and psychiatric evaluations, for instance — only to eventually repeal provisions that prove unduly onerous. That makes her optimistic that more states will eventually follow Vermont and Oregon, she said.
Milano would have preferred to travel to neighboring New Jersey, where aid in dying has been legal since 2019, but its residency requirement made that a nonstarter. And though Oregon has more providers than the largely rural state of Vermont, Milano opted for the nine-hour car ride to Burlington because it was less physically and financially draining than a cross-country trip.
The logistics were key because Milano knew she’d have to return. When she traveled to Vermont in May 2023 with her husband and her brother, she wasn’t near death. She figured that the next time she was in Vermont, it would be to request the medication. Then she’d have to wait 15 days to receive it.
The waiting period is standard to ensure that a person has what Barnard calls “thoughtful time to contemplate the decision,” although she said most have done that long before. Some states have shortened the period or, like Oregon, have a waiver option.
That waiting period can be hard on patients, on top of being away from their health care team, home, and family. Blanke said he has seen as many as 25 relatives attend the death of an Oregon resident, but out-of-staters usually bring only one person. And while finding a place to die can be a problem for Oregonians who are in care homes or hospitals that prohibit aid in dying, it’s especially challenging for nonresidents.
When Oregon lifted its residency requirement, Blanke advertised on Craigslist and used the results to compile a list of short-term accommodations, including Airbnbs, willing to allow patients to die there. Nonprofits in states with aid-in-dying laws also maintain such lists, Sandeen said.
Milano hasn’t gotten to the point where she needs to find a place to take the meds and end her life. In fact, because she had a relatively healthy year after her first trip to Vermont, she let her six-month approval period lapse.
In June, though, she headed back to open another six-month window. This time, she went with a girlfriend who has a camper van. They drove six hours to cross the state border, stopping at a playground and gift shop before sitting in a parking lot where Milano had a Zoom appointment with her doctors rather than driving three more hours to Burlington to meet in person.
“I don’t know if they do GPS tracking or IP address kind of stuff, but I would have been afraid not to be honest,” she said.
That’s not all that scares her. She worries she’ll be too sick to return to Vermont when she is ready to die. And, even if she can get there, she wonders whether she’ll have the courage to take the medication. About one-third of people approved for assisted death don’t follow through, Blanke said. For them, it’s often enough to know they have the meds — the control — to end their lives when they want.
Milano said she is grateful she has that power now while she’s still healthy enough to travel and enjoy life. “I just wish more people had the option,” she said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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The Fiber Fueled Cookbook – by Dr. Will Bulsiewicz
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We’ve previously reviewed Dr. Bulsiewicz’s book “Fiber Fuelled” (which is great), but this one is more than just a cookbook with the previous book in mind. Indeed, this is even a great stand-alone book by itself, since it explains the core principles well enough already, and then adds to it.
It’s also about a lot more than just “please eat more fiber”, though. It looks at FODMAPs, purine, histamine intolerance, celiac disease, altered gallbladder function, acid reflux, and more.
He offers a five-part strategy:
Genesis (what is the etiology of your problem)
- Restrict (cut things out to address that first)
- Observe (keep a food/symptom diary)
- Work things back in (re-add potential triggers one by one, see how it goes)
- Train your gut (your microbiome does not exist in a vacuum, and communication is two-way)
- Holistic healing (beyond the gut itself, looking at other relevant factors and aiming for synergistic support)
As for the recipes themselves, there are more than a hundred of them and they are good, so no more “how can I possibly cook [favorite dish] without [removed ingredient]?”
Bottom line: if you’d like better gut health, this book is a top-tier option for fixing existing complaints, and enjoying plain-sailing henceforth.
Click here to check out The Fiber Fueled Cookbook; your gut will thank you later!
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Avoiding Anemia (More Than Just “Get More Iron”)
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The Iron Dilemma: Factors To Consider
Anemia affects around 10% of American seniors, and that number jumps to 34–39% if there’s a comorbidity such as diabetes, hypertension, or hypercholesterolemia, which in turn climbs with increasing age or with other chronic conditions:
So, what can we do about it?
Get iron yes, but how?
We’d be remiss not to say: yes, do of course make sure you get plenty of iron.
Most people know that red meats, which are terrible for the heart and for cancer risk, are good sources of iron.
Well, good insofar as they provide plenty of it! They’re bad for other reasons.
❝Studies consistently show that consumption of red meat has been contributory to a multitude of chronic conditions such as diabetes, CVD, and malignancies.
There are various emerging reasons that strengthen this link-from the basic constituents of red meat like the heme iron component, the metabolic reactions that take place after consumption, and finally to the methods used to cook it.
The causative links show that even occasional use raises the risk of T2DM.❞
Source: Red Meat Consumption (Heme Iron Intake) and Risk for Diabetes and Comorbidities?
To heme or not to heme
Did you catch that in the middle there, about the heme iron component?
Dietary iron is broadly divided into two kinds: heme, and non-heme.
- Heme iron comes from animals
- Non-heme iron comes from plants
Bad news for vegans: non-heme iron is not so easily absorbed as heme iron.
This means that if you’re just eating plants, the RDA may be significantly lowballing the amount actually required. As a rule, about 1.8x more iron may be needed for vegans, to compensate for it being less easily absorbed.
Why this happens: it’s because of the phytic acid / phytate in the plants that contain the iron, blocking its absorption.
Good news for vegans: however, taking iron with vitamin C increases its absorption rate by about 5x better absorption, and several other side-along nutrients do similarly, including allium (from garlic), carotenoids (from many colorful plants), and fermented foods.
Why this happens: it’s because they bind with similar sites as phytic acid, without causing the same effect. To make a metaphor: these foods steal phytic acid’s parking space, so phytic acid can’t do its iron-blocking thing.
By happy coincidence, today’s featured recipe has all of these things in, by the way (vitamin C, allium, carotenoids, and fermented foods), and the star ingredient (fava beans) is a rich source of iron.
What are good sources of iron, then?
In the category of plants:
- Beans (pick your favorites / eat a variety)
- Lentils (pick your favorites / eat a variety)
- Greens (especially dark leafy greens)
- Apricots (you can get these dried, for convenience!)
- Dark chocolate (5mg per 1oz square!)*
*Ok, technically dark chocolate is not a plant; cacao is a plant; dark chocolate is usually plant-based, though, as there is no reason to add milk.
In the category of dairy products:
That’s not a publication error; dairy products are just not great for iron. Cheeses are more nutrient-dense than milk, and have less than 0.5mg per oz, in other words, the top dairy product has around 10x less iron than dark chocolate, which came in 5th place and let’s face it, we were doing broad categories there. If we listed all the beans, lentils, greens, etc it’d be a much longer list.
Eggs, which are sometimes considered under the category of dairy by virtue of not being an animal (yet!) but an animal product, have around 1mg per egg, by the way, so considering eggs are nearer 2oz, that’s not much better than the cheese.
“But what about if…”
The above is good science and general good advice for most people. That said, some people may have conditions that preclude the foods we recommended, or have other considerations, and so things may be different. Anemia can sometimes be caused by things that can’t be fixed by diet (beyond the scope of today’s article; another time, perhaps), but for example, if you have leukemia then definitely discuss things with your doctors first. Other illnesses, and some medications, can also have troublesome effects that can contribute to anemia. Again, we can offer very good general information here, but we don’t know your medical history, and our standard legal/medical disclaimer applies as always.
See also: Do We Need Animal Products To Be Healthy?
Take care!
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